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February 27, 2005
NY Times Expose- Private Health Care in Jails Can Be A Death Sentence
Sunday, February 27, 2005, Page 1 and three full additional pages.
Two additional articles will follow.
By PAUL von ZIELBAUER
http://www.nytimes.com/2005/02/27/nyregion/27jail.html?ex=1110171600&en=f4407c047b8271e8&ei=5070
If you go to the link, the article also has maps, graphs, etc.
Brian Tetrault was 44 when he was led into a dim county jail cell in upstate New York in 2001, charged with taking some skis and other items from his ex-wife's home. A former nuclear scientist who had struggled with Parkinson's disease, he began to die almost immediately, and state investigators would later discover why: The jail's medical director had cut off all but a few of the 32 pills he needed each day to quell his tremors.
Over the next 10 days, Mr. Tetrault slid into a stupor, soaked in his own sweat and urine. But he never saw the jail doctor again, and the nurses dismissed him as a faker. After his heart finally stopped, investigators said, correction officers at the Schenectady jail doctored records to make it appear he had been released before he died.
Two months later, Victoria Williams Smith, the mother of a teenage boy, was booked into another upstate jail, in Dutchess County, charged with smuggling drugs to her husband in prison. She, too, had only 10 days to live after she began complaining of chest pains. She phoned friends in desperation: The medical director would not prescribe anything more potent than Bengay or the arthritis medicine she had brought with her, investigators said. A nurse scorned her pleas to be hospitalized as a ploy to get drugs. When at last an ambulance was called, Ms. Smith was on the floor of her cell, shaking from a heart attack that would kill her within the hour. She was 35.
In these two harrowing deaths, state investigators concluded, the culprit was a for-profit corporation, Prison Health Services, that had moved aggressively into New York State in the last decade, winning jail contracts worth hundreds of millions of dollars with an enticing sales pitch: Take the messy and expensive job of providing medical care from overmatched government officials, and give it to an experienced nationwide outfit that could recruit doctors, battle lawsuits and keep costs down.
A yearlong examination of Prison Health by The New York Times reveals repeated instances of medical care that has been flawed and sometimes lethal. The company's performance around the nation has provoked criticism from judges and sheriffs, lawsuits from inmates' families and whistle-blowers, and condemnations by federal, state and local authorities. The company has paid millions of dollars in fines and settlements.
In the two deaths, and eight others across upstate New York, state investigators say they kept discovering the same failings: medical staffs trimmed to the bone, doctors underqualified or out of reach, nurses doing tasks beyond their training, prescription drugs withheld, patient records unread and employee misconduct unpunished.
Not surprisingly, Prison Health, which is based outside Nashville, is no longer working in most of those upstate jails. But it is hardly out of work. Despite a tarnished record, Prison Health has sold its promise of lower costs and better care, and become the biggest for-profit company providing medical care in jails and prisons. It has amassed 86 contracts in 28 states, and now cares for 237,000 inmates, or about one in every 10 people behind bars.
Prison Health Services says that any lapses that have occurred are far outnumbered by its successes, and that many cities and states have been pleased with its work. Company executives dispute the state's findings in the upstate deaths, saying their policy is never to deny necessary medical care.
And they say that many complaints - from litigious inmates, disgruntled employees and overzealous investigators - simply come with the hugely challenging work they have taken on.
"What we do," said Michael Catalano, the company chairman, "is provide a public health service that many others are unable or unwilling to do."
The examination of Prison Health also reveals a company that is very much a creature of a growing phenomenon: the privatization of jail and prison health care. As governments try to shed the burden of soaring medical costs - driven by the exploding problems of AIDS and mental illness among inmates - this field has become a $2 billion-a-year industry.
It is an intensely competitive world populated by a handful of companies, each striving to find enough doctors and nurses for a demanding and sometimes dangerous job. The companies, overseen by local governments with limited choices and money, regularly move from jail to jail, and scandal to scandal - often disliked but always needed.
Perhaps the most striking example of Prison Health's ability to prosper amid its set of troubles unfolded in New York State. Despite disappointed customers and official investigations in Florida and Pennsylvania, the company still managed to win its largest contract ever in 2000, when New York City agreed to pay it $254 million over three years to provide care at the correctional labyrinth on Rikers Island.
The city, in fact, just renewed that deal in January for another three years - despite the deaths upstate, and a chorus of criticism over Prison Health's work at Rikers, where employees and government monitors have complained of staff shortages and delays in drugs and treatments for H.I.V. and mental illnesses. A rash of suicides in 2003 prompted a scramble by officials to fill serious gaps in care and oversight.
Along the way, though, Prison Health has acquired at least one tenacious adversary. The State Commission of Correction, appointed by the governor to investigate every death in jail, has moved over the last several years from polite recommendations to bitter denunciations, frustrated by what it says is the company's refusal to admit and address deadly mistakes.
The commission has faulted company policies, or mistakes and misconduct by its employees, in 23 deaths of inmates in the city and six upstate counties. Fifteen times in the last four years, it has recommended that the state discipline Prison Health doctors and nurses.
And since 2001, the commission, along with the State Education Department, which regulates the practice of medicine, has urged Attorney General Eliot Spitzer to halt the company's operations in New York, saying that Prison Health lacks any legal authority to practice medicine because business executives are in charge. New York, like many other states, requires that for-profit corporations providing medical services be owned and controlled by doctors, to keep business calculations from driving medical decisions.
Prison Health says its work in New York is legal because it has set up two corporations headed by doctors to run medical care. But state investigators have called those corporations shams.
Elsewhere, Prison Health did not go that far, until questioned by The Times. Now it says it is creating doctor-run corporations in 11 other states with similar laws, including New Jersey and California.
"Had we realized this would be a question, we would have addressed it earlier," said Mr. Catalano, the company's chairman. "We have nothing to hide here."
But in one report after another, the state commission has exposed what it says is the dangerous way Prison Health has operated.
One investigation found that the doctor overseeing care in several upstate jails in 2001 - continually overruling the doctors there, and refusing drugs and treatments - was not even licensed to practice in New York State. He did the job, the commission found, by telephone - from Washington.
The commission's gravest findings have involved deaths on the company's watch, mostly of people who had not been convicted of anything.
Candy Brown, a 46-year-old Rochester woman jailed in 2000 on a parole violation, died when her withdrawal from heroin went untreated for two days as she lay in her own vomit and excrement in the Monroe County Jail, moaning and crying for help. But nurses did not call a doctor or even clean her off, investigators said. Her fellow inmates took pity and washed her face; some guards took it on themselves to ease her into a shower and a final change of clothes.
Scott Mayo Jr. was only a few minutes old in 2001 when guards fished him out of a toilet in the maternity unit of Albany County Jail. It was the guards, investigators said, who found a faint pulse in the premature baby and worked fiercely to keep his heart beating as a nurse stood by, offering little help.
"We're a jail," the nurse told state officials after the infant died. "There's no equipment for a fetus. Or a newborn."
In at least one death report, the commission took the opportunity to voice a broad indictment of the company. Frederick C. Lamy, chairman of the commission's medical review board, denounced Prison Health, or P.H.S. as it widely known, as "reckless and unprincipled in its corporate pursuits, irrespective of patient care."
"The lack of credentials, lack of training, shocking incompetence and outright misconduct" of the doctors and nurses in the case was "emblematic of P.H.S. Inc.'s conduct as a business corporation, holding itself out as a medical care provider while seemingly bereft of any quality control."
In its review of Prison Health's work, The Times interviewed government regulators, law enforcement officials and legal and medical specialists, including current and former company employees. The review included thousands of pages of public and internal company documents, state and city records, and every New York State report on deaths under the company's care.
The examination shows that in many parts of the country, including counties in New Jersey and Florida, Prison Health has become a mainstay, satisfying officials by paring expenses and marshaling medical staffs without the rules and union issues that constrain government efforts.
But elsewhere, it has hopscotched from place to place, largely unscathed by accusations that in cutting costs, it has cut corners.
Georgia, which hired Prison Health in 1995, replaced the company two years later, complaining that it had understaffed prison clinics. Similar complaints led Maine to end its contract in 2003. In Alabama, one prison has only two doctors for more than 2,200 prisoners; one AIDS specialist, before she left this month, called staffing "skeletal" and said she sometimes lacked even soap to wash her hands between treating patients.
In Philadelphia's jails, state and federal court monitors in the late 1990's told of potentially dangerous delays and gaps in treatment and medication for inmates under Prison Health, which nonetheless went on in 2000 to win a contract not far away in the Baltimore City Detention Center. There, two years later, the federal Department of Justice reported that better care might have prevented four inmate deaths. One guard, it said, complained that she had to fight nurses to get sick inmates examined.
Such stories can be heard around the country. In Las Vegas, after an H.I.V.-positive inmate died in 2002, nurses and public defenders said the county jail's medical director had refused medications for AIDS and mental illness, calling inmates junkies.
In Indiana, Barbara Logan, a former Prison Health administrator who filed a whistleblower suit last year, said in an interview that the pharmacy at her state prison was so poorly stocked that nurses often had to run out to CVS to refill routine prescriptions for diabetes and high blood pressure.
Before Prison Health even started in Georgia, there had been several inmate deaths in neighboring Florida that cost the company three county contracts, millions of dollars in settlements - and an apology for its part in the 1994 death of 46-year-old Diane Nelson. Jailed in Pinellas County on charges that she had slapped her teenage daughter, Ms. Nelson suffered a heart attack after nurses failed for two days to order the heart medication her private doctor had prescribed. As she collapsed, a nurse told her, "Stop the theatrics."
The same nurse, in a deposition, also admitted that she had joked to the jail staff, "We save money because we skip the ambulance and bring them right to the morgue."
A Tough Business: Taking On Headaches, and Creating Some, Too
Few jobs are harder to get right than tending to the health of inmates, who are sicker and more dependent on alcohol and drugs than people outside. AIDS and hepatitis have torn through cellblocks, and mental illness is a mushrooming problem. In the last decade, state and local government spending for inmate health care has tripled nationwide, to roughly $5 billion a year.
Qualified doctors and nurses are difficult to find, as jails are hardly the most prestigious or best-paying places to work. The potential costs of failure, though, are high - because most inmates will eventually be let out, along with any disease or mental illness that went untreated.
For decades the task fell to state and local governments that typically lacked resources or expertise, acting in sometimes conflicting roles as punisher and medical protector. Often, the results were tragic.
Three skeletons dug up at an Arkansas penal farm in 1968 led to the uncovering of a monstrous system in which a prison hospital served as torture chamber and a doctor as chief tormentor. The 1971 uprising at Attica state prison in upstate New York, which was sparked in part by complaints about health care, left 43 inmates and guards dead. The debacle unleashed a flood of prisoner lawsuits that culminated in a 1976 United States Supreme Court decision declaring that governments must provide adequate medical care in jails and prisons.
But where governments saw a burden, others spotted an opportunity. Two years after the ruling, a Delaware nurse named Doyle Moore founded Prison Health, pioneering a for-profit medical-care industry that offered local officials a grand solution: hand off the headache.
About 40 percent of all inmate medical care in America is now contracted to for-profit companies, led by Prison Health, its closest rival, Correctional Medical Services, and four or five others. Though the remaining 60 percent of inmate care is still supplied by governments, most often by their Health Departments, that number has been shrinking as medical expenses soar.
A few big-city hospitals and other nonprofit enterprises have stepped into the fray, and while not perfect themselves, have performed the best by many accounts, bringing a sense of mission to the work. But that care usually costs more than governments want to spend, and most hospitals are neither equipped nor motivated to enter a jail or prison, where profit margins linger in the single digits.
In this world, where governments are limited in their choices, a half-dozen for-profit companies jockey to underbid each other and promise the biggest savings.
"It's almost like a game of attrition, where the companies will take bids for amounts that you just can't do it," said Dr. Michael Puisis, a national expert and editor of "Clinical Practice in Correctional Medicine," an anthology of articles by doctors. "They figure out how to make money after they get the contract."
Businesses with the most dubious track records can survive, and thrive. When cost-trimming cuts into the quality of care, harming inmates and prompting lawsuits and investigations, governments often see no alternatives but to keep the company, or hire another, then another when that one fails - a revolving-door process that sometimes ends with governments rehiring the company they fired years earlier.
Prison Health has mastered the game. When its mistakes have become public, the company has quietly settled lawsuits and nimbly brokered its exits by quickly resigning, thus preserving its marketable claim that it has never been let go for cause.
Even dissatisfied government clients can be reluctant to discuss their complaints openly, or share them with other counties or states. Some fear being exposed to lawsuits and criticism; others worry that the company dropped this year may return next year as the only bidder for the job. Or, as some former Prison Health customers discovered to their dismay, the new company they hire may be bought by the company they fired.
"You've got the professionals dealing with amateurs," said Dr. Ronald Shansky, a former medical director for the Illinois prison system. He said most sheriffs and jailers were not sophisticated enough about medicine to know what to demand for their money until things go wrong. Local laws requiring that contracts be regularly put out for bid - and go to the lowest bidder - can force officials to switch providers constantly, disrupting care and demoralizing staffs.
Yet once they turn jail medicine over to an outside enterprise, governments rarely go back to providing it themselves. "It's like an article of faith that private is better," Dr. Shansky said, even though a 1997 study comparing government and for-profit prison care, commissioned by the Michigan Department of Corrections, found little difference in cost or quality.
On this playing field, Prison Health has prevailed by thinking big, buying up competitors and creating a nationwide pharmacy to supply its operations. Its revenues have risen in the last decade to an estimated $690 million last year from $110 million in 1994, and its stock has leapt to $27.46 a share - its closing price on Friday - from a split-adjusted price of $3.33.
But day by day, Prison Health - like all of its competitors - faces the most basic challenge: finding people to do the job. For openings in Philadelphia last year, it advertised on a Web page called the Job Resource. "Psychiatrists - Feel shackled to an unsatisfying job? Discover correctional medicine!" said one ad. A Las Vegas posting urged, "Come do some time with us!"
Those who Prison Health hires wind up responsible for the legion of people locked up every day. When the doors shut behind them, the care those prisoners get is shuttered from public view. Deaths behind bars provoke scant outcry.
But if the public has little information about inmates, and not much inclination to care, it may have even less sympathy for the notion that they should die for want of medical attention.
Cutting a Lifeline: For Parkinson's Patient, a Countdown to Death
Four days into his stay at the Schenectady County Jail, it all began to come apart for Brian Richard Tetrault. He could no longer walk the four steps from his bunk to the door of Cell 22, in A-block, where a nurse was waiting with his small ration of pills.
Since his arrest, the state commission said, he had been denied most of the medication he had used for a decade to control his Parkinson's disease and psychological problems. The medical staff knew about his ailments from the day he arrived, soft-spoken and clutching a plastic pill organizer; they even phoned his doctor for his charts.
But the jail's medical director took him off all but two of his seven medications, and nurses concluded that the new inmate was more uncooperative than ill, state investigators said. Mr. Tetrault, a former nuclear scientist at the nearby Knolls Atomic Power Laboratory, had only seven days left before an agonizing death that investigators would label "physician induced."
He had grown up in the Albany suburbs, a hunter and amateur mechanic with a gift for mathematics. He joined the Navy, and spent a year on classified missions in a nuclear submarine. By 1990, he had a wife and two sons, a house on a lake and his pick of good-paying jobs in nuclear engineering.
But try as he did to ignore its slow trespass, Parkinson's ruined everything. His sister Barbara first noticed how his hand shook during a game of pinochle. By 1995, Mr. Tetrault was popping prescription Sinemet tablets every two hours to counter the loss of dopamine, a brain chemical vital to muscle function. Every day became a battle with dyskinesia, the drug-induced tremors common to Parkinson's patients.
"He'd call it 'disky,' " said Larry Broderick, a high school friend. "He'd say, 'I'm getting disky.' "
By 2001, the disease had destroyed Mr. Tetrault's marriage and estranged his two teenage sons. His ex-wife, Eileen, had obtained an order of protection as he grew increasingly depressed and angry. That Nov. 10, he stormed into her home while she was away and snatched some items - skis and a push broom - before the police arrived and charged him with burglary and harassment.
His mistreatment began that day, according to the state commission. Without seeing Mr. Tetrault, the jail's medical director, Dr. W. J. Duke Dufresne, prescribed Sinemet and an anti-ulcer drug, but none of the other five medications for his Parkinson's, pain and psychiatric troubles.
On his second day in jail, Mr. Tetrault saw Dr. Dufresne, the only physician for the jail's 300 or so inmates. In a brief visit, the commission said, the doctor reduced even the Sinemet. As for the mental health drugs, Dr. Dufresne later told investigators that only a psychiatrist should prescribe them.
But no one ever arranged for Mr. Tetrault to see the jail psychiatrist, the commission said. And never again did he see Dr. Dufresne, who told investigators he had believed that Mr. Tetrault was merely feeling the typical ups and downs of Parkinson's; he had planned to check on him in three months.
Mr. Tetrault had only days. On his fourth day in jail, medical records show, he grew increasingly "disky" and belligerent, as his body withdrew from the medications that had sustained him for years. On the sixth day, he lay in his bunk, steeped in his own urine and unable to move. "Continues to be manipulative," a nurse wrote.
On the seventh day, the commission said, nurses continued to look in on him, chronicle his deterioration and do little about it. "Inmate remains very stiff," one wrote. "Head arched back, sweating profusely," another noted. A third nurse forced him to walk to the jail clinic, though he could barely move.
On the eighth day, alerted by a nurse's phone call, Dr. Dufresne ordered Mr. Tetrault hospitalized. At Ellis Hospital in Schenectady, emergency-room doctors diagnosed the ravages of his untreated Parkinson's. "I suspect, in the prison setting, he was not getting his full dose of medication as needed," wrote Dr. Richard B. Brooks.
There was not much the hospital could do. On the 10th day, Mr. Tetrault went into septic shock. On the 11th, he died.
The state commission ultimately referred Dr. Dufresne to the State Board for Professional Medical Conduct for what it alleged was "grossly inadequate" care, urged Prison Health to fire him and asked the county to fire Prison Health.
The commission found that Dr. Dufresne had never given Mr. Tetrault a physical examination; and nurses had transcribed the doctor's orders incorrectly, reducing even the Sinemet.
The medical conduct board has taken no action against Dr. Dufresne. The company, in its lawyer's response to the commission, disputed virtually all of the commission's findings, saying that Mr. Tetrault sometimes resisted taking his medication, and that he was well able to move when he wanted. The company's internal one-page review of Mr. Tetrault's care passed no judgment on the doctor or the nurses. But it did recommend six minor changes, like keeping medical records in chronological order. Dr. Dufresne, who is now the company's regional medical director for upstate jails, did not return calls seeking comment.
Richard D. Wright, the president and chief executive of Prison Health, would not discuss details of the case, citing a lawsuit by Mr. Tetrault's son Zachary. He said that over all, Schenectady County "was extremely pleased with the work of the company."
But the county moved to fire Prison Health the day after the commission's report was made public last June. "We were going to terminate them for cause," said Chris Gardner, the county attorney. "But they approached us and we mutually agreed to terminate the relationship."
The humiliation of Mr. Tetrault did not end with his passing, or with Prison Health, the commission said. On the day he died, Nov. 20, 2001, sheriff's officials altered records to change the time of his release from custody, in the early evening, to 2:45 p.m. - 10 minutes before he was pronounced dead, the commission said. The Sheriff's Department denied the charge, and said it had done nothing untoward in trying to formally release Mr. Tetrault.
But the commission said the time change allowed the department to avoid an investigation, at least for a while. Commissioners learned of Mr. Tetrault's death by reading a newspaper article about Zachary's lawsuit, 20 months later.
The Revolving Door: After Trouble in Florida, Moving On, and Up
If Schenectady County was learning hard lessons about Prison Health, it was old news in South Florida, where several counties had tangled, and re-tangled, with the company years earlier.
By the time Pinellas County hired Prison Health in 1992, the company was hitting its stride. Fourteen years after its founding, it had established a wide beachhead in the state, and had just begun a nationwide push that by the end of the decade would put it in the three biggest cities of the Northeast and the prison systems of entire states. A year earlier, the company began selling stock under the name of a holding company, America Service Group.
But for Pinellas, halfway down Florida's Gulf Coast, things were headed downhill.
Everett S. Rice, who was sheriff then, said that Prison Health understaffed the county jail in Clearwater. The company seemed reluctant, he said, to send seriously ill inmates to hospitals, which could cost it thousands of dollars a day. Inmates were regularly showing up in court incompetent to stand trial, said Bob Dillinger, the county public defender, because they were not getting their psychiatric medicines.
The sheriff's office learned that even the most basic care had to be spelled out in the contract. When one inmate died after a delay in calling for help, Mr. Rice said, the agreement was rewritten to require that Prison Health call 911 at a specific time after the start of a medical emergency.
Then, in March 1994, came the death of Diane Nelson, who collapsed of a heart attack in front of the nurse whose words would echo in news reports: "We save money because we skip the ambulance."
Saving money was the reason the county had hired Prison Health. Pinellas was actually on its second round with the company, having first enlisted it in 1986 because of worries about the ballooning costs of the county's own jail health care. When the contract went back out for bid three years later, Pinellas switched to a cheaper competitor; three years after that, Prison Health bid the lowest and retook the job.
But Mr. Rice said the bidding process never turned up a whisper of criticism about Prison Health, or any of its competitors. "Every time we'd be up for renewal, we'd talk to the other counties and institutions, and surprisingly, most of them had glowing reports," he said.
In the end, the deal with Prison Health "probably saved a little money," Mr. Rice said, but the human and political costs were too high. "I thought if I'm going to get the blame for this, I'm going to bring it back inside," he said.
The county did that in April 1995, going back into the business of jail medical care. Three months later, an hour's drive to the east, rural Polk County - which had hired Prison Health the same year as Pinellas - broke off with the company after three inmate deaths that cost Polk taxpayers thousands of dollars in settlements.
"There were instances where we would actually send somebody to the hospital by ambulance because P.H.S. wouldn't do so," said David Bergdoll, counsel to the Polk County Sheriff's office.
Since 1992, at least 15 inmates have died in 11 Florida jails in cases where Prison Health appears to have provided inadequate care, according to documents and interviews with state and county officials.
As it grew, Prison Health proved adept at ingratiating itself with local politicians, hiring lobbyists and contributing to campaigns for sheriff. Under a promise of immunity from prosecution, the nurse who founded the company, Mr. Moore, testified at a 1993 Florida corruption trial that he had paid the Broward County Republican chairman $5,000 a month - "basically extortion," he said - to keep the contract there and in neighboring Palm Beach County.
Some counties say Prison Health has done good work and saved taxpayers money. In Tampa, the medical bill at the Hillsborough County Jail fell to $1.2 million, from $1.8 million in 1982, the year Prison Health replaced the county's medical operation, said Col. David M. Parrish, who runs the jail.
There have been other costs. Last year, the company dismissed a nurse and reprimanded two others after an inmate's baby died; the mother, Kimberly Grey, said in a federal lawsuit that although she had been leaking amniotic fluid for five days, nurses refused to examine her until she gave birth over a cell toilet.
But Colonel Parrish said that mistakes, and second-guessing, were part of the job, no matter who does it. "Anybody who is in the health care business for inmates is going to get blasted because inmates have nothing better to do than complain and sue and find somebody who is going to make a big stink about nothing," he said.
Certainly, a litany of complaints followed as Prison Health expanded across the nation. In Philadelphia, a 1999 federal court monitor's report warned that the company's failure to segregate inmates who were suffering from tuberculosis posed "a public health emergency." Pregnant inmates, it said, were not routinely tested or counseled for H.I.V., endangering their babies.
Dr. Robert Cohen, a state court monitor, said in an interview that Philadelphia doctors "actually encouraged women to refuse pelvic examinations."
Prison Health still works in Philadelphia, where officials have persistently prodded it to improve care. Like many governments, the city has moved from a fixed-cost contract in which the company's profit comes out of whatever it does not spend to one that covers most medical costs and pays Prison Health a management fee.
When other governments have shown less patience, Prison Health has survived, and even grown, by buying rivals like Correctional Health Services, of Verona, N.J. In 1999, its biggest purchase, EMSA Government Services, brought with it contracts with dozens of prisons and jails.
Back in Florida, the purchase brought some unwelcome déjà vu to Polk County, which thought it was through with Prison Health when it hired EMSA. When Prison Health bought EMSA, Polk officials soon replaced it yet again.
"P.H.S. was the lowest bidder, but we didn't accept their bid," said Mr. Bergdoll, the sheriff's counsel. "That should tell you something." Since then, he said, the number of lawsuits has fallen so sharply that the county's insurer lowered its premiums.
The EMSA purchase also brought Prison Health back to Broward County, Fla., which had dropped it years earlier because it had been unhappy with the medical care. Two years after its return, three state judges noticed the phenomenon that had played out in Pinellas - a parade of inmates showing up in court incoherent - and ordered the company to stop withholding psychiatric drugs.
"My impression was that it was money," Judge Susan Lebow said in an interview. "The doctors were under corporate direction to not continue the medications."
Prison Health denies it gave any such order. The Broward sheriff would not comment on the company, which the county replaced again in 2001.
But the revolving door of for-profit health care spins on. Last December, Broward hired Armor Correctional Health Services, a company formed just a few weeks earlier by a familiar figure: Doyle Moore, the nurse who founded Prison Health.
A Jailhouse Birth: Chaos on a Cell Floor as a Baby Is Discovered
It could not have been much worse. A newborn baby lay in a pool of blood on the floor of the Albany County Jail. At least four adults were there: the mother, a registered nurse and two correction officers who struggled to save the tiny boy. But the nurse looked on passively, tending to the dazed mother, convinced that little could be done, state records show.
The baby, who was named Scott Mayo Jr., died two days later.
The mistreatment and missed chances to help the young mother, Aja Venny, began soon after her arrival 11 days earlier, investigators said. A 22-year-old secretary and community-college student from the Bronx, she knew she had done something stupid: taken a ride with a drug dealer she knew from her neighborhood. When a state trooper pulled them over, she stuffed his small bags of drugs into her bra.
She was booked into jail on Aug. 30, 2001, nearly six months pregnant.
The medical staff made an appointment with an obstetrician it paid to visit every two weeks, but Ms. Venny never saw him, state investigators said; nurses ordered her files from a Bronx women's clinic, but never received them. The one concession to her condition, it seems, was her assignment to the maternity unit, a six-bunk cell with a toilet cordoned off by a white curtain.
On Sept. 9, Ms. Venny awoke before dawn with excruciating cramps. Another inmate told the guard that Ms. Venny was about to give birth. After two calls to the nursing supervisor, Donna Hunt, a jail sergeant sent an officer to fetch her immediately.
When she arrived at 7:15 a.m., Ms. Hunt found Ms. Venny sitting on the toilet crying and "blood everywhere," she told investigators. She cleaned off and consoled the inmate, and told the officers to call an ambulance. She said later that she assumed that Ms. Venny had miscarried and saw no reason to check the toilet.
But ambulance technicians, on the phone with the sergeant, asked if there was a baby. Guards looked in the toilet and discovered the infant, still in his placental sac. Officer Dave Verrelli scooped him out using a red biohazard waste bag and laid him on a towel on the cell floor as Nurse Hunt watched.
"I knew that there was probably nothing we could do for this fetus," she told investigators.
Officer Verrelli detected a slight pulse. "What should I do now?" he frantically asked the nurse, who told him to cut open the sac. Officer Verrelli cut it, removed the baby and uncoiled the umbilical cord from its neck. Ms. Hunt confirmed that there was a faint heartbeat, investigators said, but did nothing to get the baby breathing in the quarter-hour before ambulance workers arrived and administered oxygen.
At the hospital, the boy was placed on a ventilator, his heart pumping but his temperature too low to be measured. On his third day of life, he died.
The State Board of Regents found that three Prison Health nurses, including Ms. Hunt, had failed to care properly for Ms. Venny or her baby. Each nurse was placed on a year's probation and fined $500. The State Commission of Correction did not say whether anyone might have saved the child, but it emphasized that Ms. Hunt did not take basic steps to help. She did not return calls seeking comment.
The commission also found more deep-seated failures: a disorganized staff and prenatal training for nurses that consisted of e-mail messages with instructions copied from a university Web site.
Prison Health's lawyers defended Nurse Hunt - saying she found the child in the toilet, but was pushed aside by guards - and accused the commission of ignoring "inconvenient facts."
Ms. Venny, who completed a six-month boot-camp prison program after her son's death, now lives in the Bronx with her husband, Scott, and their 20-month-old daughter, Skye. The ashes of Scott Jr. are kept in a golden urn in the bedroom.
"I know what I was doing was wrong," she said. But still, "I can't find a reason why a baby had to die."
Connecting the Deaths: A Pattern Emerges, and a Battle Begins
It was late 2000 when state investigators began to notice something strange. Reviewing deaths that had occurred in jails in upstate New York, they were not struck by the number or even the grim details of the cases, which they routinely examined as employees of the State Commission of Correction. Something else was wrong.
Working out of a cluttered office in Albany, the three commissioners and a six-member medical review board noticed that low-level employees were doing work normally done by better-credentialed people. Nurses without the proper qualifications, they said, were making medical decisions and pronouncing patients dead.
In Rochester, where Candy Brown had died that September, pleading for help as she withdrew from heroin, investigators found that one of the nurses responsible for her had been suspended by the state three times for negligent care.
In that case and others, commission members said, the people offering the most help and compassion were guards and inmates. And the company, it turned out, was always the same: Prison Health.
"Our sense was that what we were dealing with was not clinical problems but business practices," said James E. Lawrence, the commission's director of operations.
It was the start of a long fight to get the company to change its ways, and when that failed, to get other officials in Albany to step in. Four years later, the commission has been stymied on both fronts.
Mr. Lawrence said Prison Health seemed unfamiliar with New York's tradition of regulated health care, "and dismissive of it." When the agency sought out those in charge, it would often be routed to lawyers or executives at the company's headquarters in Brentwood, Tenn., who bristled at the suggestion that they were answerable to New York State regulators. "The rules were not of any consequence," Mr. Lawrence said.
Prison Health entered New York in 1985 as medical provider for the Dutchess County Jail. Orange and Broome Counties hired the company for a few years, but ended those contracts in the 1990's.
By late 2000, when the company began to attract the state commission's notice, it had signed contracts with Schenectady, Ulster, Monroe and Albany Counties. The Albany jail superintendent at the time called the company "a godsend."
The commission called it a disaster. "Grossly and flagrantly inadequate," for instance, was its verdict on the care given Candy Brown.
Prison Health, in turn, challenged the commission's authority, and even sued over its report on one inmate's treatment, saying the panel had acted maliciously. The suit was dismissed on its merits.
Dr. Carl J. Keldie, the corporation's medical director, said the commission seemed to make up its mind before an investigation and then overstate its case in reports. "The tone, the timbre, the language is egregious," he said. Company executives said the commission has refused to meet and try to reconcile their differences.
The commission in 2001 moved beyond the specific criticisms in its reports to sound a general alarm. Asking state education officials to investigate, it said Prison Health was allowing "dangerously substandard medicine" by hiring doctors and nurses with questionable credentials.
A month later, spurred by the commission, the Department of Education alerted the state attorney general that the company was operating illegally in New York by not having doctors in charge of medical care. "Nobody really noticed that they weren't licensed," one commission doctor said of Prison Health's presence in New York.
In the three years since, nothing has come of either complaint. The only agency with the power to enforce the state law - the attorney general's office - finally replied last October, telling the commission to resolve the matter on its own. In a heated exchange of letters, an assistant attorney general, Ronda C. Lustman, scolded the commission for refusing to meet with executives.
The company says that it is acting legally because it has set up local corporations with doctors in charge. But there is abundant evidence, state investigators say, that those corporations are shams.
For example, Dr. Trevor Parks is listed as the sole shareholder of P.H.S. Medical Services P.C., which the company says provides all medical care at Rikers Island, free of any influence from Prison Health executives. But investigators say that when they interviewed him, he had little idea of his role, or his corporation's.
Moreover, records show that Dr. Parks's corporation went out of business in July, for nonpayment of taxes and fees. After The Times pointed that out to company executives in December, Prison Health paid the money. Dr. Parks did not respond to phone calls and e-mail messages.
If frustration mounted at the commission, a sense of impending trouble was growing at the jail in Albany County, where the commission said doctors' decisions on inmate treatment were being overruled by a regional medical director in Washington who was not licensed to practice in New York.
The doctor, Akin Ayeni, said in an interview that he never overruled any doctor there. But a former medical director at the jail said she quit in April 2001 because she felt the company's policies, and Dr. Ayeni's decisions, were dangerous.
"I told my staff, 'I know it's only a matter of time before they kill someone,' " she said, asking that her name not be used because she feared retribution. "I knew there was going to be a death. I could feel it."
In the six months after she left, two people died and a third was seriously injured after poor treatment by Prison Health, the state commission found; the dead included Aja Venny's newborn son.
The county and the company parted ways six months later, said Thomas J. Wigger, the jail superintendent, because he was unsatisfied with the quality of care.
One by one, other counties have followed suit. Ulster County, for example, caught Prison Health overbilling it for thousands of dollars of nurse hours and switched to another company in 2001. The company, for its part, said it lost most of the upstate contracts to competitors who had underbid them. Strangely, it said it had no record of working in Orange County, even though the state commission faulted the company in two inmate deaths, in 1989 and 1990.
Last October, Schenectady County dropped Prison Health after the death of Mr. Tetrault, the inmate with Parkinson's disease. The jail director, Maj. Robert Elwell, said in an interview that the medical director, Dr. Dufresne, had discouraged treatment for anything but the most urgent problems. "When you're dealing with a for-profit corporation, those are the types of decisions that get made," Major Elwell said.
The company's only remaining outpost in upstate New York is Dutchess County. "I believe they are a good company," said David W. Rugar, the county jail administrator. "It's just an intense thing to do, when you provide medical services."
Indeed, just days before it renewed its deal with Prison Health in 2002, the jail had an intense experience that would cost the company's medical director there his job.
Cries From the Heart: Despite Days of Agony, 'Nobody Will Help Me'
When they cleaned out Cell 6 in Unit 10 on Feb. 16, 2002, workers at the Dutchess County Jail found a letter that Victoria Williams Smith had written to her husband.
"My chest is tight & burns, my arms are numb," it said. "I been to the nurse about five times & no body will help me. I need to get out of this jail. It feels like I'm having a stroke, no bull."
Actually, it was a heart attack, and it had killed Ms. Smith a few hours earlier at the age of 35. The letter was just one in a skein of increasingly panicked pleas for help during her last 10 days in jail.
Ms. Smith was born in Brooklyn, but settled in North Carolina with her second husband, Justin Smith. They married in 1997, shortly after he was sent to a prison in Dutchess County for attempted robbery.
She shipped him canned food that he could sell for cash, and in January 2002 drove to the prison for what friends said was a visit allowed to married couples.
The reunion was called off by state troopers, who were waiting at the prison to search her. They found about seven ounces of heroin clearly intended for her husband to use or sell, state records show.
Thirteen days passed, state investigators said, before Ms. Smith was examined by a doctor: Vidyadhara A. Kagali, the part-time medical director at the jail in Poughkeepsie, who worked only on Wednesday and Friday evenings even though he was responsible for about 300 inmates.
She could have hoped for better. Dr. Kagali, who was board certified only as a pathologist, had never treated patients in a hospital and had "limited knowledge of his responsibilities as jail medical director," according to commission records.
On Feb. 6, when she began to complain of chest pains and numbness, Dr. Kagali told her she was suffering from inflamed cartilage in her chest, and had her continue taking the Vioxx arthritis medication that friends in North Carolina mailed to her.
The next day, after Ms. Smith was found crying in pain in her cell, an electrocardiogram revealed abnormalities in her heart. But Dr. Kagali, notified by a nurse, did not see her, according to the state commission. On her third day in jail, records show, a second EKG showed the same heart problem, but the doctor still did not see her.
On the seventh day, a nurse turned to the jail's part-time psychiatrist for help in easing Ms. Smith's chest pain and labored breathing. Without seeing her, he prescribed a drug for intestinal problems. On the eighth day, Dr. Kagali saw Ms. Smith; he ordered a spinal X-ray and recommended Bengay.
Two days later, in tears, she phoned her North Carolina friends, Chris and Marjorie Bowers, three times. "She said these people would not help her at all," Ms. Bowers said.
In the early morning of Feb. 16, Ms. Smith's untreated heart ailment became an emergency, according to jail records and sworn statements from nurses and guards. Around 4:30 a.m., a guard found her rocking on her bunk, clutching her chest, and called Barbara Light, the registered nurse on duty.
Ms. Light concluded that Ms. Smith was having an anxiety attack - even though, the commission said, the nurse had never seen the inmate's medical record.
A half-hour later, Ms. Smith, weeping, told the guard she wanted to go to a hospital - a plea Nurse Light dismissed as an attempt to get drugs. Minutes after that, the guard placed a frantic third call to the nurse, who arrived to find the inmate on the floor, shaking. An ambulance rushed Ms. Smith to Vassar Brothers Medical Center, where she died in less than an hour.
The state commission, in its report, seemed hardly to know where to begin to catalog the failures.
It urged that Dr. Kagali be fired for "gross incompetence," and referred Ms. Light to state regulators for discipline. State health authorities eventually suspended the doctor's license for six months, but have not taken action against Ms. Light. Neither she nor Dr. Kagali would comment.
The company's confidential review of Ms. Smith's death found no fault with her treatment, but recommended that its staff offer grief counseling to colleagues and inmates after future jail deaths.
In a letter to the commission, Prison Health defended Ms. Light and Dr. Kagali. It said that over Ms. Smith's five weeks in jail the doctor had seen her numerous times and provided medications, knee braces and even an extra mattress for her arthritis. Ms. Smith had no known history of heart disease, the company said, and any suggestion that her death could have been prevented was "20-20 hindsight."
The letter was signed by Dr. Dufresne, whom the commission would later blame for Brian Tetrault's death.
Joseph Plambeck contributed reporting for this article.
Copyright 2005 The New York Times Company
Posted by lois at 02:49 PM | Comments (0)
February 26, 2005
CO: Sex, contraband in Private Prison for Women
Casper Star Tribune Friday, February 25, 2005
By The Associated Press
DENVER (AP) -- The warden of the privately run Brush Correctional Facility for Women has resigned and five officers face sexual misconduct and contraband charges.
Warden Rick Soares quit Tennessee-based GRW, which owns the 250-bed prison in Brush, on Feb. 18, said Alison Morgan, spokeswoman for the state corrections department. The warden was not implicated in any wrongdoing.
The facility, which became the first private prison for women in Colorado in August 2003, holds 80 inmates from Hawaii, 73 from Colorado and 45 from Wyoming.
The corrections department referred contraband allegations involving two staff members and one inmate and sexual misconduct allegations involving three staff members to District Attorney Robert Watson on Thursday.
Three officers had sex with four Hawaiian inmates, two Colorado inmates and one Wyoming inmate, Morgan said. Two of the officers have resigned and a third is on administrative leave.
Some of the women say they were raped, but investigators concluded the sex was consensual and sometimes was initiated by inmates, Morgan said. Having sex with inmates is a felony offense for correctional officers.
She said some Hawaiian and Wyoming inmates acknowledged they had sex with the guards because they believed they would be returned home, where they would be closer to relatives.
As for the contraband allegations, Morgan said two officers and an inmate were caught sneaking tobacco into the prison on the plains of northeastern Colorado.
The Department of Corrections is sending 20 experts to train and mentor Brush prison officers for the next 30 days, she said.
http://www.casperstartribune.net/news/wyoming/613d3e097c73fe0887256fb30045d313.txt
Posted by lois at 10:31 AM | Comments (0)
Kansas AG Seeks Late Term Abortion Records
February 25, 2005
Kan. AG Seeks Late - Term Abortion Records
By THE ASSOCIATED PRESS
TOPEKA, Kan. (AP) -- The Kansas attorney general, a staunch opponent of abortion, has demanded the medical records of nearly 90 woman and girls who had late-term abortions, saying he needs the material to investigate crimes.
The two abortion clinics involved in the case say the state has no right to such personal information and are fighting the request in the Kansas Supreme Court.
But Attorney General Phill Kline insisted Thursday he needs the records because he has ``the duty to investigate and prosecute child rape and other crimes in order to protect Kansas children.''
Sex involving someone under 16 is illegal in Kansas, and it is illegal in the state for doctors to perform an abortion after 22 weeks unless there is reason to believe it is needed to protect the mother's health.
Kline spoke to reporters after details of the secret investigation, which began in October, surfaced in a legal brief filed by attorneys for the two clinics. The clinics argued that unless the high court intervenes, women who obtained abortions could find government agents knocking at their door.
The clinics said Kline demanded their complete, unedited medical records for women and girls who sought abortions at least 22 weeks into their pregnancies in 2003. Court papers did not identify the clinics.
The records sought include the patient's name, medical history, details of her sex life, birth control practices and psychological profile.
The clinics are offering to provide records with some key information, including names, edited out.
``These women's rights will be sacrificed if this fishing expedition is not halted or narrowed,'' the clinics said in court papers.
On Oct. 21, state District Judge Richard Anderson ruled that Kline could have the files. The clinics then filed an appeal with the high court. No hearing has been scheduled.
The clinics outlined their legal arguments in a brief filed Tuesday. Though other documents in the case remain sealed, the brief filed Tuesday was not, and The Wichita Eagle disclosed Kline's investigation in a story published Thursday.
In their brief, the clinics' attorneys said a gag order prevents the clinics from even disclosing to patients that their records are being sought. Attorneys declined to comment Thursday, citing the order.
``You can see our desire to discuss as much as possible, but we feel constrained,'' said attorney Lee Thompson.
Thompson declined to say if his client was Dr. George Tiller, whose Wichita clinic is known as a provider of late-term abortions and is a frequent target of abortion opponents.
Kline would not discuss the scope of the investigation. Recently, Kline's office helped Texas authorities gather information from Tiller regarding a pregnant teenager who sought his care and died in Kansas.
Kline in 2003 began pushing to require health care professionals to report underage sexual activity. Kline contends state law requires such reporting, but a federal judge blocked him. The case has yet to be resolved.
Copyright 2005 The Associated Press
Posted by lois at 10:08 AM | Comments (0)
February 24, 2005
Ban on Voting for People with Felony Convictions Hurts Blacks and Democrats
By Earl Ofari Hutchinson, AlterNet
Posted on February 17, 2005, Printed on February 24, 2005
http://www.alternet.org/story/21300/
During the last presidential campaign Democratic presidential candidate John Kerry tepidly spoke out against the ban by some states on ex-felon voting. He should have shouted out against it. The ban hurts Democrats far more than Republicans. Blacks make up a huge percentage of those barred from voting because of a prison stint. They are far more likely to vote Democrat than Republican.
The ex-felon vote ban in Florida in 2000 did much to snatch the White House from Al Gore. The ban on ex-felon voting also may have deprived Kerry of thousands of potential votes in Ohio. That almost certainly helped swell Bush's vote total in that pivotal state, and insure his White House return. Kerry, and top Democrats have said and done little since the election to get states to modify or scrap their vote bans. The Sentencing Project, in a recent report, again noted that more than a dozen states still permanently bar ex-cons from voting, or make it so difficult for them to get their rights restored that for all practical purposes they're banned from voting for life. Blacks are still the hardest hit by the bans. One in four adult black men are effectively disenfranchised by the bans.
It's no accident that five of the dozen states that perpetuate this morally and legally indefensible practice are Southern states. The South has had a long and deplorable history of devising an arsenal of racially abusive tactics including poll taxes, literacy laws and political gerrymandering to drive blacks from the voting booths.
This thinly disguised relic of the South's Jim Crow past has done much to drastically dilute black political strength. In 1996 about 4.5 million black men voted in the presidential election. If the 1 million black men in prison, on parole, or probation that were disenfranchised because of their criminal record had been added to the total their vote might have made a crucial difference in deciding close statewide contests.
Black ex-felon disenfranchisement will probably get worse. Blacks now make up nearly half of the more than 2 million prisoners in the nation's jails. The entrenchment of racially biased drug laws, racial profiling, and chronic poverty in many black communities means that more black men will be arrested, prosecuted, convicted and serve longer prison sentences than white men. This virtually guarantees that the number of blacks behind bars will swell. The Sentencing Project estimates that at the present rate of black incarceration upwards of 40 percent of black men could be permanently barred from the polls in the vote restricted states in the next few years. And since most state officials are scared stiff of being publicly labeled as soft on crime, state legislatures have either ignored the issue or stonewalled legislation that would end the archaic practice.
Congress can take a big step toward rectifying this blatant injustice by passing the still pending Civic Participation and Rehabilitation Act. It would not effect voting in state elections but it would restore voting rights to ex-felons in federal elections.
It will take a fierce fight to get this bill passed. Many conservatives passionately defend the policy of ex-felon disenfranchisement. They claim that in barring criminals from voting society sends the strong message that if you break the law you should pay, and continue to pay dearly. The argument might make sense if all or most of the disenfranchised ex-felons were convicted murderers, rapists or robbers. And they were denied the vote because of a court-imposed sentence. This is not the case.
None of the states that bar felons from voting in near perpetuity require that judges strip them of their voting rights as part of their sentence based on the seriousness of the crime or the severity of the punishment. The majority of ex-felons are jailed for non-violent crimes such as drug possession, passing bad checks, or auto theft. In most instances they fully served their sentence and in theory paid their debt to society.
Most of the convicted felons were young men when they committed their crime. The odds are that most of them won't become career criminals, but will hold steady jobs, raise families and become responsible members of the community. Yet imprinting these ex-felons with the legal and social stigma of "hereditary criminals" and banning them from voting until death makes politicians and many Americans seem like the worst kind of hypocrites when they say they believe in giving prisoners a second chance in life.
Civil liberties groups and civil rights organizations must fight harder against the bans. That means filing court challenges and mounting a sustained lobbying campaign in Congress or state legislatures to get the discriminatory voting laws changed.
The denial of voting rights to thousands of blacks decades after the end of slavery and legal segregation is a travesty of justice, and a blot on the democratic process. It will also cost the Democrats thousands of votes and maybe even the White House in the next presidential election.
© 2005 Independent Media Institute. All rights reserved.
View this story online at: http://www.alternet.org/story/21300/
Posted by lois at 10:18 PM | Comments (0)
People with felony convictions could vote under Let Every Vote Count Legislation
"....In addition, Count Every Vote would allow ex-felons to vote in federal elections...."
2/23/2005
By Matthew Cardinale
The House Democrat who signed the challenge to Ohio’s electoral votes spoke passionately about her new Count Every Vote Act, a bill aimed at enhancing federal election standards to address problems which arose in recent elections. The bill, said Rep. Stephanie Tubbs-Jones (D-OH), seeks to ensure guidelines regarding provisional ballots and paper records for electronic voting. It would also create a federal voting holiday and allow ex-felons to vote. Tubbs-Jones, a former judge, relished the opportunity to flesh out the bill, saying Tuesday that the mainstream press had focused largely on specific provisions. “I was on a radio show recently and the guy kept wanting to focus on the provision to make Election Day a national holiday,†Rep. Tubbs-Jones said.
The Sentate version of the bill was introduced by Sen. Hillary Clinton (D-NY) on behalf of Sens. Boxer (D-CA), Kerry (D-MA), Lautenberg (D-NJ), and Milkulski (D-MD). Comparable legislation was introduced by Tubbs-Jones (D-OH) in the House. The bill would mandate certain aspects of how states run federal elections. It would require a voter-verified paper trail for electronic voting, create uniform standards for provisional ballots, and make Election Day a national holiday.
In addition, Count Every Vote would allow ex-felons to vote in federal elections, make electronic voting source codes available for government record, and prevent Secretaries of State from participating in partisan campaign activities.
The bill also includes federal funding provisions to assist states’ compliance. Common Cause, a progressive advocacy group, said they appreciated the fact the bill addressed myriad issues. “While there are other specific single bills already out there, like the paper trail for electronic voting bill, this bill is meant to set the Gold Standard for fixing these problems,†Common Cause Vice President of Policy and Research Ed Davis said. “The federal government has passed very few mandates regarding voting,†Davis added. “Even if they are specific to federal elections, it typically pushes states to follow them too, because it doesn’t make much sense for states to hold two separate elections.†Paper Trail Rep. Tubbs-Jones asserts that a paper trail for electronic voting is essential. “Computers are by no means flawless,†the congresswoman told
“We brandish freedom and democracy around the world; why not here?†she asked. Provisional Ballots Count Every Vote also provides guidelines for creating a uniform process of handling provisional ballots. “In Ohio in 2004, our Secretary of State [Kenneth Blackwell] issued different rules in the Primary Election and the General Election regarding provisional ballots,†Congresswoman Tubbs-Jones said. “What he did was within the law–but the point is, he made it so restrictive. Currently states’ laws on provisional ballots are so different.†“Provisional ballots are really a backup,†added Ed Davis of Common Cause. “The problem is not usually with voters, but with voter lists. There are duplicate names, or sometimes states purge the names of people who should be registered.
“Different states purge voters for a variety of reasons; some states do it because a person didn’t vote in the last two years,†Davis continued.
“Also, sometimes officials will tell voters to go to the wrong polling place… Then on Election Day, there’s no time to direct people to the right precinct, that is, if polling places even have that information,†he added. “If you show up at the wrong precinct in some states, they won’t count your ballot. You shouldn’t be prevented from voting for President for any reason.†Davis says Democrats
Click Here
will need to win over Republicans to get the legislation passed. In the overall elections policy landscape this year, Davis explained, “Republicans are more concerned with voter fraud, and Democrats think it should be easier for people to vote,” and that voter fraud is not as a widespread problem as voting barriers and disenfranchisement. “Republicans have tried to avoid this issue because to admit that something needs to be fixed is like admitting something was wrong with the 2004 election,†Davis added.
Matthew Cardinale is a freelance writer, advocate, and graduate student in sociology and democracy studies. He may be reached at mcardina@uci.edu. Other news related to mass incarceration can be found at www.
Posted by lois at 10:13 PM | Comments (0)
Confusing Rules Deny Vote to People With Felony Convictions
February 20, 2005, NY Times
By ERIC LICHTBLAU
WASHINGTON, Feb. 19 - An estimated 1.5 million former convicts are unable to vote in 14 states around the country because of state policies that make it cumbersome, confusing and difficult for them to return to voter rolls after completing their sentences, according to a new study.
Fewer than 3 percent of felons in those states have managed to register to vote after finishing their sentences, according to the study released Wednesday by the Sentencing Project, a nonprofit research group that favors more liberal sentencing policies for criminals.
In Mississippi, for instance, just 107 of more than 82,000 felons have had their voting rights restored since 1992 after completing their sentences, the study found, and in Nebraska, the tally was 343 of more than 44,000.
The question of whether and how former convicts should be allowed to vote has generated a growing nationwide debate in recent months.
The issue became contentious in Florida in the 2000 election and again last year because of accusations that felons, many of them members of minority groups, were effectively being blocked from re-registering, while some Republicans in Washington State asserted that felons were voting illegally in last year's close race for governor.
The Supreme Court declined last year to consider differing interpretations from two appellate courts on the power of states to strip felons of the right to vote. Legislators in some states have pushed to loosen restrictions on registering felons, but others have advocated expanding the types of crimes that would make an offender ineligible to vote.
At the federal level, Democrats in the Senate and House, including Senators Hillary Rodham Clinton of New York and Barbara Boxer of California, introduced legislation this week that addresses the issue. Among a host of other proposals for ensuring that "every vote is counted," the legislation seeks to restore voting rights "for felons who have repaid their debt to society" and would require states to end the practice of denying voting rights to felons who have completed their prison terms, parole or probation, the sponsors said.
The Sentencing Project said its study was the first to survey how frequently felons were denied voting rights in states with restrictive policies. It examined 14 states that do not automatically restore voting rights to felons after they complete their sentences. Those states are Alabama, Arizona, Delaware, Florida, Iowa, Kentucky, Maryland, Mississippi, Nebraska, Nevada, Tennessee, Virginia, Washington and Wyoming.
The study found that Florida, with 48,000 felons returned to voting ranks, was the only state where a significant number had their voting rights restored, but only after extended court battles there.
The report blamed long and confusing waiting periods before felons can seek voting eligibility, inadequate data in state records systems, and arbitrary standards. Some states, like Florida and Kentucky, employ "character tests" that allow state officials to ask felons about their drinking habits or to require them to submit letters of reference in applying for voting rights, the report said.
"What we found is that the procedures in many states for restoring felons' voting rights are so little used and so cumbersome that the possibility of getting restored voting rights for many of these people is just illusory," Marc Mauer, the assistant director of the Sentencing Project, said in an interview.
Several officials involved in state voting procedures did not dispute the study's findings but said they were taking steps to make it easier for felons to register when allowed by state law.
Meredith Imwalle, a spokeswoman for the National Association of Secretaries of State, said a continuing overhaul of state voting databases should help to ease the problem by linking voter rolls in many states to criminal and corrections records.
In Mississippi, a state singled out by the Sentencing Project, a felon guilty of murder, rape or a number of other crimes that result in disenfranchisement must appeal to the governor or the Legislature to regain the right to vote.
"I would say that it is rare for that to happen, as the numbers in this study seem to reflect, so it may in fact be easier for a felon to regain the right to vote in other states," said David Blount, a spokesman for the Mississippi secretary of state's office.
But Mr. Blount said Mississippi, like some other states, was limited in its options because it would take an amendment to the State Constitution to change the procedure.
Copyright 2005 The New York Times Company
Posted by lois at 10:04 PM | Comments (0)
Eastern NY Correctional Facility: "Uncaptive Minds"
February 20, 2005, NY Times Magazine
By IAN BURUMA
''The admission process,'' Kenner said recently, ''is emotionally the hardest part of our work. Up to 200 apply for 15 spots.'' Only 50 students, out of a prison population of more than 1,200, are now enrolled. "
The main business of Napanoch, N.Y., is a maximum-security prison, Eastern New York Correctional Facility, also known as Happy Nap. The population of Eastern, 1,250 men, many from New York City, is about the same as that of Napanoch itself. Imposing in a hideous kind of way, the prison, built at the end of the 19th century, is modeled after a medieval fortress, with towers and turrets and a pyramid roof. The overall effect -- stony pomposity framed by lush green hills -- is rather Germanic.
There is nothing particularly happy about Napanoch, situated on the raffish edges of the Catskills about 70 miles north of Manhattan; its better days as an affordable resort area for New York and New Jersey Jews have long gone. There are a few motels nearby with cracked signs that read Starlite and Eldorado; a diner; a Jewish cemetery; and a ''colony farm,'' where the original inmates of Eastern, mentally impaired delinquents, were put to work in the early decades of the 20th century.
There is, however, a reason that inmates call the prison Happy Nap. Eastern is more relaxed than other maximum-security prisons, or ''maxes,'' in upstate New York, with less hostility between staff and prisoners, and as a result fewer U.I.'s, or ''unusual incidents'' -- stabbings and the like. It is said that the farther upstate you go, the harsher the prison conditions can be. Among New York's maxes, Eastern has one of the best reputations. It is one of only three maximum-security prisons in the state where you can still get an education -- not just in manual skills, but a proper college education with a degree at the end, thanks to privately financed initiatives.
One person to have benefited from such an education is Mika'il DeVeaux, a slim, 48-year-old black man who served 25 years for murder. DeVeaux studied theology at Sing Sing and got an M.A. in sociology. After he was released in October 2003, he founded an organization in New York with his wife called Citizens Against Recidivism. DeVeaux likes to point out how much prison education reduces the chances of ex-convicts falling back through the revolving door of crime and imprisonment. That's why, according to DeVeaux, ''Eastern is the place to be.''
Education programs used to be widely available in prisons in the United States, especially after the notorious Attica rebellion in 1971, which left 43 dead. Among the demands of the inmates, who were pressing for improved prison conditions, was a better education program. This demand was met, not only at Attica but also in prisons around the country. Over the next decades, prison education flourished. Then, in 1994, Congress effectively abolished all federally financed college education for prison inmates when it voted to eliminate Pell Grants for federal and state prisons, despite strong resistance from the Department of Education. Critics pointed out that education greatly reduces recidivism; only one-tenth of 1 percent of the Pell Grant budget went to the education of prisoners anyway. But Senator Kay Bailey Hutchison, a Republican of Texas, argued that it was unfair for felons to benefit from Pell Grants when as many as 100,000 low-income students were denied them each year. Why should prisoners be educated for nothing when so many honest folks failed to get a break? And besides, she said, the federal government already spent upward of $100 million on prison education and training programs. Today, what federal money is spent on prisoner education goes largely toward vocational training.
Hutchison's arguments arose from a more generalized desire -- not just among Republicans -- to get tough on crime, or more precisely on criminals. Even though crime rates were actually dropping in the 90's, many argued that judges were letting felons off too lightly and that the ''rights'' of victims needed to be taken into account. Thus, beginning in the early 90's, prison regimes were tightened, even as mandatory minimum sentences and three-strikes laws meant more and more people came into the system and stayed. In this climate few politicians were ready to stand up for higher-education programs for prisoners. Before 1995 there were some 350 college-degree programs for prisoners in the United States. Today there are about a dozen, four of them in New York State.
The Bard prison initiative was set up by Max Kenner, who graduated from Bard College in 2001. After Kenner finished school, he spent the summer driving around from prison to prison, meeting with staff members and inmates to find out what kind of education program was most needed. He found many administrators receptive to the idea of a higher-education program; there was overwhelming enthusiasm among the inmates. And Eastern, thanks to its relatively liberal regime under its superintendent, David Miller, was the most hospitable, and agreed to be host of the pilot program.
The Bard Prison Initiative now runs an associate degree program at Eastern. There are plans to introduce a bachelor's program soon. Inmates have to go through an application process like any prospective college student: an essay, test scores, transcripts (G.E.D.'s for those who didn't finish high school) and an interview by Kenner and his colleague Daniel Karpowitz. ''The admission process,'' Kenner said recently, ''is emotionally the hardest part of our work. Up to 200 apply for 15 spots.'' Only 50 students, out of a prison population of more than 1,200, are now enrolled.
I'd been teaching at Bard during the spring semester for several years, commuting from London, where I lived, so I knew about the program. When I signed up last year, Kenner told me the students would be interested in learning about East Asian culture. So, somewhat to my surprise, I found myself teaching a course in modern Japanese history. The idea of talking about samurai rebellions, Japanese imperialism and General MacArthur's occupation to men who were in for drug dealing, grand larceny and murder, was certainly intriguing but also somewhat daunting. How much did they know? How should I approach the material? Would they be at all receptive?
entered Eastern on a cold day last February. Flurries of sleet made the fortresslike prison look even bleaker than usual. After being put through a metal detector and frisked, I heard the iron gates close behind me with a thud. My ''escort,'' in charge of education, was a friendly woman named Theresa with the jaunty air of a popular coach.
The first thing you notice inside is the spotlessness of the floors, which is no wonder, since there are always men around mopping and buffing. We walked through a narrow corridor with yellow lines on the floor. Inmates in olive green uniforms filing past us greeted Theresa with elaborate courtesy. Several blind men were being led around by fellow prisoners. Being physically impaired has its advantages; a bit more leniency is shown by the guards, which is why, Kenner told me, some prisoners pretend to be blind or deaf, a ruse that rarely works for long. One young white prisoner greeted me in German. I showed my surprise. ''Ja,'' he said, ''I'm the only one.'' Then I noticed a peculiar smell. Theresa must have spotted my wrinkled nose. ''Skunks,'' she explained. ''There are skunks under the floors.''
My first class was held in the vocational section, where inmates engage in metalwork and other manual tasks. Eastern is well known as a producer of dog tags and street signs. Since prison rules dictate that all men in ''voc'' wear work boots and pass through metal detectors, my students did not like coming here. It meant they had to take off their boots and belts and submit to a body search, always a humiliating business. My class of nine consisted of a Puerto Rican, who had been to the Bronx High School of Science, one of New York's prestigious magnet schools; two white military veterans; a Vietnamese-American; four black men, two of them Muslims; and one young white man who had been incarcerated since he was 16.
I had been assured by Kenner and Karpowitz that the students would be enthusiastic. This was an understatement. But as I learned in my first weeks of teaching, the main difference between these students and those on the Bard campus was their polite formality. I was invariably addressed as ''professor,'' not so much for my sake, I sensed, as for their own self-respect. Somewhat patronizingly, I suppose, I had expected talk about sword-fight movies and Oriental wisdom. Instead, from the very start, questions of a far more sophisticated kind came quick and fast: about the economics of the Opium Wars in China, about the criminal activities of unemployed samurai, about the impact on Japanese cultural identity of Western ideas. One of the black Muslims, a tough New Yorker, mentioned Alexis de Tocqueville in the context of the Meiji Restoration.
The students were smart, streetwise and funny, and I found it impossible not to be charmed by them. They were also clearly grateful to be in class, where they were treated as intelligent adults. It is easy to feel a little smug about dealing with these men, to feel a sentimental solidarity with them against the guards and the rest of their oppressive world. This soon leads to the kind of phoniness that any inmate can see through in an instant.
One form observed in prison is that you don't ask what someone is in for -- unless you're in for something, too. You may not get a straight answer anyway. Deputy Superintendent Sheryl Butler, a spirited woman in her 50's, told me that I didn't want to know the students' crimes. ''Otherwise you can't deal with them objectively,'' she said. Kenner told me the same thing. But I couldn't contain my curiosity and looked up their sentences on the department of corrections Web site. Of course, even what I could find out didn't tell me much: second-degree murder could be armed robbery, a gangland killing, the murder of a wife. But it helped me to keep some perspective whenever I was tempted to see the inmates purely as victims, suppressed by vicious guards.
I never witnessed any serious oppression, just the imposition of endless petty rules. The students remained remarkably calm, even when they were provoked. They knew they had no choice. It was hard enough getting into the education program. One false move could cost a student his place in the classroom, and in Happy Nap too.
It is a tricky situation. Education widens the gap between students and corrections officers and can easily increase hostility. Many of the officers have not been to college themselves and probably don't expect their children to either. But higher-education programs should also make life easier for the C.O.'s, since the prisoners who benefit from them are more inclined to behave themselves. Indeed, a C.O. once told a colleague of mine that life at Eastern was a trifle dull. At the previous institution where he'd worked there were shakedowns, stabbings on the galleries, mayhem in the solitary-housing unit. At Eastern, a guard was liable to fall asleep.
My second class was on the failed samurai rebellion in the 1870's against the Westernized Meiji government, on which the movie ''The Last Samurai'' was very loosely based. I mentioned a book, by Ivan Morris, titled ''The Nobility of Failure,'' and explained the admiration in Japan for rebels who die for lost causes. We discussed how this ethos compared with the American celebration of success. Perhaps, I said a bit facetiously, there was no such thing as a noble failure in America. One Muslim among my students laughed and said, ''This room's full of them.''
Everyone had his own story, one that could quickly curdle into despair. One warm day in April, after two months of teaching, I attended an anniversary celebration of the Bard Prison Initiative at Eastern. A jazz band of inmates and volunteers was playing in the yard, while prisoners in white aprons served lemonade and chocolate cake. Speeches were made, by inmates and by Superintendent Miller, who has the avuncular manner of a rural bank manager. Words like ''respect'' and ''future'' and ''self-improvement'' flew thick and fast. The sun was shining, but one of my students, catching my eye, whispered, ''It's miserable.''
Stories of failure and despair vary. You can never be sure how much is true. His came in a flood of words: regularly beaten by a drunken stepfather, kicked out of the house at 14, placed in a foster home, where he felt sheltered for the first time in his life until he discovered that the foster father was sexually abusing his charges. He was so incensed, he said, that he killed the man with a kitchen knife. He told me that he still becomes enraged at the thought of men abusing innocent women and children. Since he's been in jail, he has spent most of his time reading and writing. Books are his salvation, he said. He dreams of being a famous author. He has at least 12 1/2 more years of his sentence to go.
It was obvious to me, as a teacher, how precious education was to the students, not only because they could practically recite every sentence of the books and articles I gave them to read but also because of the way they behaved to one another. Prisons breed cynicism. Trust is frequently betrayed and friendships severed when a prisoner is transferred without warning to another facility. The classroom was an exception. We talked about Japanese history, but also about other things; one topic led to another. One day a guest lecturer spoke about pan-Asianism in the 1930's -- the Japanese aim to unite and dominate Asia by defeating the Western empires. My Vietnamese student remarked that he was a pan-Asianist with ''a small a,'' but that really he was a ''panhumanist,'' for ''we are all one race, right?'' One of the black students snorted in a good-natured way. The Vietnamese smiled and said: ''I know we have disagreements about that.''
There cannot be many places -- in or outside prison -- where blacks, Asians, Hispanics, Muslims and Caucasians can discuss race and religion without showing hostility. A Muslim student, a big man from the Bronx, said he'd encountered little animosity to Muslims in prison. ''Sure, that's because we know each other,'' another student said. I found this surprising, since prisons are not known for racial or religious tolerance. But perhaps they were referring not to the prison system in general, or even to the narrower confines of Eastern, but simply to the class. Then a black student, in for robbery, piped up: ''If I hadn't been in prison, I'd never have met any Jewish guys. I had all the stereotypes in my head, you know, cheap and mean. But now I'm hanging with a Jewish guy the longest time.''
Eastern is different. But why? Why was Eastern more receptive to the Bard Prison Initiative than other prisons in the state? Why is Eastern ''the place to be''? Several men pointed out that ''the tone is set by the top.'' The superintendent and his deputy both started their careers as teachers.
Deputy Superintendent Butler likes to refer to Eastern as a ''therapeutic community.'' She has spent decades of her life inside the prison. Her son works there now. Eastern is her community, too. Walking around the prison one day, she sounded almost wistful when she told me about the flowers she'd received from inmates when she was hospitalized for a serious illness. I asked her about the trouble that inmates had making friends, when they know they might be transferred at any time. She replied that inmates get ''very attached to staff, too, you know. They have tears when they leave. We bring them up, like our children.''
This is not the kind of thing you'd expect to hear from corrections officers in most maximum-security facilities. There is no doubting Butler's benevolent intentions. Like her boss, Butler has been consistently supportive of education programs at Eastern. And the relative decency with which inmates are treated by the C.O.'s has much to do with the example set by Miller and Butler.
Something Butler said to me still sticks in my mind. She was speaking about the benefits of education for men who would never leave prison. ''You know,'' she said, ''if you have a body'' -- that is, if you've been involved in a murder -- ''you're in for life.'' She kept returning to this point, even though most men do eventually get out. It was almost as if Butler did not really want her charges to leave.
I spoke about my impression to Mika'il DeVeaux, the ex-convict who started Citizens Against Recidivism. ''Deputy Butler,'' he said, ''wants to be the Eastern mother. She'll mother you, and if that's not what you want, she'll bully you.'' This can be disconcerting to some inmates. I heard one of them say that at least in more ''old-fashioned'' institutions, you knew where you stood; it was ''us'' against ''them,'' and a prisoner would not even dream of talking to a C.O. And yet, as DeVeaux also pointed out, ''it is a rare man who asks to be transferred out of Eastern.''
Butler has known some prisoners for many years. I knew my students for only a few months. Yet I, too, found it hard to say goodbye. It is difficult to know what they really think of the teachers. We were not C.O.'s, to be sure, but still people on the outside. I do know what they think of Max Kenner, who threw them a lifeline when the government refused them an education. He is a hero to men who had little confidence left in humanity, including their own. It isn't much -- a few dozen men out of a thousand who can study for a Bard College degree, but to those men it is everything. It costs the state about $32,000 a year to keep a person in jail. It costs the Bard Prison Initiative only $2,000 to provide a student with a year of college education.
On my last day at Eastern, I turned back toward the prison as I was leaving. There, high above me, I could just make out a face, pressed against the bars of a cell. It was my youngest student, the one who knifed his foster father. As I drove off, I glanced into my rearview mirror. All that moved in the mass of brick and steel bars behind me was a pale arm waving.
Ian Buruma, a teacher at Bard, last wrote for the magazine about Iraq.
Copyright 2005 The New York Times Company
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TX: ACLU Calls for Taser Moratorium
Feb. 23, 2005, 12:34PM
Policy review is needed after man's death, ACLU says
By PEGGY O'HARE
Copyright 2005 Houston Chronicle
The American Civil Liberties Union is calling for police departments across Texas to stop using Tasers until policies and training are reviewed in the wake of a Houston man's death on Friday.
The ACLU's call for a moratorium was spurred, in part, by the death of mental health patient Joel Casey, who died on his 52nd birthday after being shocked by a Taser gun while fighting with Harris County Precinct 1 deputy constables. Casey's exact cause of death has not been determined, but deputies later learned he had a history of heart problems and hepatitis B — issues not disclosed in paperwork sent by a private psychiatric center to the constable's office.
Even so, local law enforcement agencies polled Tuesday say they have no plans and have not heard of any intentions by their command staffs to stop using the Tasers. They say the stun gun has proved to be a valuable tool and consider it a success.
ACLU chapters in Colorado and northern California have sought similar moratoriums. Just last week, a sheriff in Toledo, Ohio, suspended his office's use of Tasers after an inmate who died was shocked with the stun gun many times at a county jail.
Meanwhile, a civil rights activist expressed concern about how often Tasers are used by Houston Police Department officers. Houston police have used Tasers about 140 times since the devices were bought in November — a rate of about one or two instances a day, said HPD Lt. Robert Manzo.
Friday's death and HPD's statistics have ignited a long-simmering debate about whether Tasers are safe and whether police use them too liberally.
Casey's death Friday marked the first time in Houston a person has become unresponsive and died after being shocked by a Taser. Deputies would not have used a Taser on Casey had they known of his heart problems, Precinct 1 Chief Deputy J.C. Mosier said.
Paperwork from the private psychiatric and drug treatment program DAPA did not indicate Casey had health problems or communicable diseases, Mosier said. The acronym "NA" — not applicable — was listed in both categories, he said.
"I'm not necessarily blaming them. It's just we didn't have all the information we needed. Who's responsible for that, I don't know," Mosier said.
DAPA, in the 6200 block of Westpark, did not return calls seeking comment Tuesday.
Man shocked 3 times
Casey was shocked by a Taser three times during the fight in the 4100 block of Meyerwood, but the device seemed to have no effect, according to the deputies' statements. One deputy wrote that the jolt seemed to make Casey "rage uncontrollably," Mosier said.
Casey was zapped once in the upper chest , but he continued fighting with the deputies, reports show. After a second jolt, Casey knocked the Taser out of a deputy's hand. The Taser was then used a third time.
After being handcuffed and put in the back seat of a patrol car, Casey tried to kick out the windows, Mosier said. Deputies then removed him from the car, put him on the ground and put leg cuffs on him. When they put him back in the car, they saw he wasn't breathing, Mosier said. Casey died at a hospital.
"I'll tell you something — I don't believe the Taser had anything to do with this," Mosier said of the man's death.
Studies to determine Casey's cause of death were pending Tuesday night, the Harris County Medical Examiner's Office said.
Casey's death is "the quintessential straw that broke the camel's back," said Will Harrell, executive director of the ACLU of Texas.
The organization is seeking a moratorium on the use of Tasers "until we can be assured of adequate training and policies on their use," Harrell said.
"It's clear the police either don't know the power of what they hold in their hands today, or are abusing it."
Local police deny that, saying Tasers have proved their worth and reduce injuries. HPD, the Harris County Sheriff's Department and the Precinct 1 Constable's Office say they have no plans or are not aware of any intentions to put their use of Tasers on hold.
"Our officers are trained only to use the minimum amount of force necessary to bring an individual into compliance," said Manzo.
Using devices too much?
The Sheriff's Office also is satisfied with the Taser, which it calls a valuable tool.
Sheriff's Maj. Mike Smith, who supervises the patrol division said he is "continuously amazed" at the misconception that Tasers were bought only so officers could avoid using their firearms. "It does not necessarily replace the firearm," he said.
But that raises another debate — whether police use Tasers too freely or easily.
One advocate whose son was shot to death by Houston police in 1998 said she fears officers turn to Tasers too frequently and that agencies do not put enough restrictions on them.
"Originally, I thought they would be a good thing and would save lives, but it seems like they are being used when maybe they shouldn't be," said Susan Hartnett, a founder of Civilians Down, a group that monitors police use of force. "To say that someone with mental illness was being difficult seems like an easy way to justify using a Taser when something else, like talking and being calm, may have worked."
Edward Jackson, a spokesman for Amnesty International USA, took particular issue with HPD using the Taser 140 times since November, calling the statistic "cause for alarm."
"It makes absolutely no sense at all ... that police would still be so cavalier in their use of Tasers," said Jackson, a Houston native whose father is a former Houston police officer.
"It's an indication one of two things is going on — either there is a violent crime spree in Houston that is of epidemic proportions that the police are not telling the public about; or they're using Tasers in situations where they would not use batons or pepper spray or guns or any other type of force," Jackson said.
Manzo said HPD's numbers must be taken into proper perspective, considering more than 1,000 of the devices have been distributed among its officers throughout the city.
Reporter Roma Khanna contributed to this report.
peggy.ohare@chron.com
Posted by lois at 06:51 PM | Comments (0)
TX: Interview with Tony Fabelo on why he was silenced by Gov. Rick Perry
Over two decades Fabelo would transform the council into an unbiased source of data and planning for one of the largest prison systems in the world. The council studied everything from prison costs and upkeep to the effectiveness of drug treatment programs. Astoundingly, 1 out of every 20 Texans are under the control of the Texas Department of Criminal Justice either in prison, parole, or on probation. Fabelo created order from chaos. “We must have a criminal justice policy council,” Senate Criminal Justice Committee Chairman John Whitmire (D-Houston) told The Houston Chronicle upon hearing of Perry’s veto. “It’s critical to the state’s public safety net that we have experts like Dr. Fabelo around.”
Texas Observor 2/18/200
They Shot More than a Messenger
Governer Rick Perry silenced Tony Fabelo. Now, hear what he has to say.
BY JAKE BERNSTEIN
n June 2003, at the end of the regular session of the 78th Legislature, Governor Rick Perry abolished an entire agency with a line-item veto. The agency had a biannual budget of only $2.5 million, but Perry’s action will likely end up costing the state much more than that. For an institution that was unique in the nation, the agency had a rather bland name—the Criminal Justice Policy Council. It had started in 1984 as a council of elected officials tasked with forcing agencies dealing with the criminal justice system to work together. One of its first employees was a freshly minted doctorate from the University of Texas named Tony Fabelo.
Over two decades Fabelo would transform the council into an unbiased source of data and planning for one of the largest prison systems in the world. The council studied everything from prison costs and upkeep to the effectiveness of drug treatment programs. Astoundingly, 1 out of every 20 Texans are under the control of the Texas Department of Criminal Justice either in prison, parole, or on probation. Fabelo created order from chaos. “We must have a criminal justice policy council,” Senate Criminal Justice Committee Chairman John Whitmire (D-Houston) told The Houston Chronicle upon hearing of Perry’s veto. “It’s critical to the state’s public safety net that we have experts like Dr. Fabelo around.”
Why Perry removed Fabelo is a favorite guessing game of those who work on the advocacy side of the system. The official line from the governor’s office was that the council, created to act “as an independent agency to assist with solutions to prison overcrowding” was superfluous, its demise a money saver. For those who don’t swallow that line, there are at least three different conspiracy theories detailing which hidden interest did in the straight-talking civil servant. Many, aware that a few key players in the lobby run much of the Lege, believe it was Fabelo’s appraisal of privatization—grounded in realism and not ideology. In this theory, it was a corporate deal and Mike Toomey’s fingerprints are all over the axe. Toomey was a lobbyist whose clients included private-prison behemoth Corrections Corporation of America. He helped engineer the 2002-coordinated Republican campaign to seize the Legislature—currently under investigation by a Travis County grand jury. He then became Rick Perry’s chief of staff. (Toomey is back in the lobby for the 79th Legislature: see, “Texas’ First Post-Modern Lobbyist,” TO, December 17, 2004.)
Theory number two had Fabelo done in by faith, so to speak. The council did a study comparing faith-based treatment programs to those offered by the state. It found that, while faith-based programs saved the state money, recidivism rates were about the same. Both approaches failed to keep prisoners engaged or successfully integrate them back into their communities. According to this theory, faith-based Republicans, a key bloc in any Perry primary victory, are responsible for killing the council. Last but not least is the current prison crisis. The Legislative Budget Board, which subsumed many of the council’s responsibilities, says the state prison system could be at capacity by March. Fabelo had predicted as much the session before. A crisis in the prison system is not something to trumpet when running for reelection. The next best thing to solving the problem is minimizing its importance.
None of this need concern Fabelo anymore. His value is clear to officials in five states where he is working as a consultant. He is also helping out in Puerto Rico, his boyhood home. Born in Cuba, Fabelo’s parents spirited their young son off the island after the revolution. They were headed to Spain on a tourist visa, but when the boat stopped in Puerto Rico, his father asked for political asylum. Fabelo laughs as he tells the story from his South Austin home. Throughout the house are touches of the islands. It’s clear in talking to the bearded and perpetually pensive Fabelo that he still cares deeply about Texas and the criminal justice system he spent almost 20 years trying to fine tune. What follows are excerpts from that conversation.
The Texas Observer: There seems to be evidence that other states that didn’t have Texas’ prison building boom also had crime rates that went down. Are we safer or just poorer?
Tony Fabelo: It is a combination of everything. We had such a crisis. We let the system get so out of control in the ’80s. We neglected to have adequate capacity. We neglected to really pay attention to how the war on drugs was having an impact on sentences, or pay attention to the probation infrastructure and so forth. We had such a crisis that we had a gigantic backlog in the county jails. The counties sued the state and won, and we had to pay the counties half a billion dollars over a period of, I think, six years for holding the prisoners in their county jails and for penalties the court decided to impose on the county jails. So at that point, really, there was no choice but to build.
We were in a tremendous bind. There were a lot of releases. The parole rate was 80 percent. When we release at 80 percent, you’re not making good release decisions. So, we released [violent offenders] and they became the poster cases for this situation. So the parole board was shut down, and releases started declining, which aggravated the whole overcrowding. [It] was totally out of whack. So there was no choice given the situation but to build prisons and get the system stable. So in that regard we had to build prisons and we did have an impact on crime, because eventually we had a more stable system where the violent offenders were serving longer.
The other answer to your question is, if we continue to do this, are we just putting more money in this thing, and getting the same returns on the investment? We are getting to the point where we have the highest incarceration rate in the country, the third highest right now. We have about the same prison population as California, [which] has 13 million more people. And that gives you a sense of how high our incarceration rate is. In terms of crime rates, there are other states that saw declines in crime, particularly New York, [which had a] tremendous decline in crime. They did a lot better in terms of crime rate decline even though their incarceration rates did not increase as much.
Right now with the highest incarceration rate in the country, with a projected shortfall in capacity of about 6,000 to 8,000 beds in the next five, six years, there is not enough capacity. If we build more prisons and build 8,000 prison beds, and that would cost a lot of money nowadays, probably over $1 billion, are you going to get dramatic declines in crime? The answer is no. [We] won’t.
TO: What are the other parts of the system that we need to enhance?
TF: The first one is probation. The probation system in Texas is not a very effective system. Half of the probationers that terminate probation terminate because of a revocation. We have about 30,000 absconders at any point in time, from probation. We don’t even know where these guys are. These are felon probationers. The problem with the probation system is that we have very long supervision terms. We have the longest supervision terms in the country. These people stay there for a long time, so that’s why we end up with 250,000 felonies on probation—more than California, and then another 150,000 or so in misdemeanor probation. The caseloads [for probation officers] are 100 to 116 for felony probations. Which means that the probation officer cannot do much with these people, except to figure out if they’re reporting or not.
So we have a system that—if you’re a probationer and you get in trouble, you don’t get a lot of services, you don’t get a lot of attention that can help you get out of trouble. In particular, attention with employment problems, substance abuse problems and so forth. On the other hand, if you’re doing well on probation, you stay on probation forever because you’re paying fees and they generate money for the system. Half of the funding of the system comes from fees paid by probationers. [For every $1 the state invests, probation collects $1.13 in offender fees for supervision, victim restitution, court costs, and fines.] So if you’re doing well, stay on probation for a long time. Thanks for paying for the system! If you’re not doing as well, we slap you in the face a couple of times, don’t give you a lot of attention in terms of good programs and casework supervision, and then all of a sudden we revoke you.
TO: What would the ideal caseload for probation officers look like?
TF: It varies. Some people say seven. But look, we did this in the juvenile system when Bush was here and that was one of the proudest things I did when I was working there with Governor Bush. He came in and said we need to fix our juvenile system. And part of the fix was to increase time for the most violent juvenile offenders. But the other part of the fix was to strengthen probation. So they put more money into juvenile probation. They put in a system of progressive sanctions. [A] staircase system of how kids will move. If you don’t do it good in step one, we’re going to take you to step two. And put programs behind that; and the caseloads went down—right now I think it’s 1 [probation officer] to 26. And they were way up before the reform: 1 to 70 and so forth. By every measure the numbers are now better, even recidivism, the numbers are better. Now, that’s a smaller system. It’s a system of very short terms. If you’re in juvenile probation you don’t stay on forever like adult probation. You stay on for a year, we try to do something with you to make you better, and in that year, we hope that you don’t come back. And that is exactly what happened. So the same logic needs to apply to the adult system. It hasn’t been applied because you will need funding to replace all these fees that you’re not going to have when you cut the probation terms.
But the solution is very clear: First, you need to cut probation terms. We are talking non-violent offenders. We’re not talking about sex offenders. Most of the probationers are non-violent offenders. So you cut the terms, have very strong supervision for the first year. Strong supervision means not only the guy knocking on your door but making sure you go to the counseling that you need and all that jazz. If you survive that first year, we’re going to put you in another year with lower supervision and see if you survive that second year. And if you do, you’re off the hook. You’ve done good. Studies have shown—I’m doing some work in Virginia—79 percent of the violations that lead to revocation occur in the first eight months. So, most of the stuff happens that first year. And you can do another year just to make sure that now they can follow the rules. If you do that, you will cut the numbers of people on probation substantially.
TO: How do we prepare people for re-entry? Is there a good way? Is it something that the state should invest in more?
TF: We sure don’t prepare them by just opening the door and giving them fifty bucks [laughs] “Okay people, take the bus and good luck!”
I mean, we sure don’t. And this is a national initiative [to deal with this problem]. In Connecticut for example, we identify through mapping studies the higher-risk neighborhoods in New Haven and Hartford. We’re working with the Council of State Governments there, which is a national organization that is also looking at criminal justice issues. And we identify million-dollar neighborhoods. These are neighborhoods where you superimpose the criminal justice supervision costs with welfare costs and employment assistance costs and all that. They’re receiving all the state money, okay? But it is being received by different pots [sic] of people that are not well coordinated.
So part of the initiative that just got adopted is to go back to those neighborhoods, working with all the agencies, not only the criminal justice agencies but their mental health, substance abuse agency, and probation agency, and the Department of Corrections, to try to see how to coordinate these services better. Identify the people going to those communities early on. Start the re-entry process in the prison system. Transition them to those communities [where] they [can] get an array of services that might be paid for by different [public and private groups]. But it’s an array of services oriented at trying to make these people succeed in the community. We call it “justice reinvestment.”
So we’re trying that in Connecticut. We’re going to try it in Arizona. We’re going to try it in Kansas. Those are our three sites that we selected for this year. The people there are all gung-ho about it. And they’re very different states. Connecticut is, let’s say, more liberal, although they have a Republican governor. Kansas is conservative. Arizona is very conservative. But they’re looking at this picture and saying, this makes sense. How can we get out of [having] to build prisons and more prisons? In Connecticut I think it was 60, 70 percent of the people coming back to prison were coming back from [the same] neighborhoods, in New Haven and Hartford. So if you do something there, and you’re better at delivering the resources, you can cut criminal justice costs; and, ironically, reinvest the money that would be freed up—in theory—back in those communities to continue to enhance that.
TO: Do you think the nation, or maybe even Texas, is getting close to a prison tipping point where across the ideological spectrum there is an acknowledgement that it’s not working and something has to be done?
TF: Yes. We have reached that in Texas. We have reached that tipping point, I think. Nationwide, you have that conversation where you have Senator Brownback from Kansas, for example, conservative Republican, talking about the need to improve re-entry, and actually being very involved in this issue nationwide along with what you might call more liberal elected officials. President Bush raised the issue of improving re-entry and dealing with this population in the State of the Union address and that has generated lot of interest. Faith-based communities are behind this and, you know, they are very conservative but they’re behind this. They were behind the adoption of the prison rape bill that was just passed in Congress to prevent rapes in prison. There’s a second part to that bill to enhance community capacity to deal with these populations going back.
I think you have an ideological consensus that violent offenders should be locked up for a long time. But I also think you’re getting a development of an ideological consensus about what we do in these communities with these drug offenders that are substance abusers. I don’t think the consensus is clear yet there. There is a lot of debate around mandatory sentences and so forth. But I think there’s a consensus developing. Now you can have that consensus and nothing gets done. So, you need the leadership to forge that consensus into something that gets done—and that is the key.
TO: Is privatization the magic bullet that some people think it is? And if not, why not?
TF: I think privatization has a role in all this, and Texas has led the way on privatization. So it has a role. It depends where, how, and at what cost? So I don’t think it’s a magic bullet. If some people think we can privatize the whole prison system—that is pretty hard to do. It might cost less now but it’s going to cost you a lot more later. My feelings with privatization is that you have to figure out where it fits and how it fits, for what populations, what performance you expect from them, and work that into the contract arrangement. And if it reduces costs, it’s okay. But it has its limits.
There is no magic bullet in any of this. The magic bullet is to have a long-term commitment to improve your probation infrastructure in such a way that you cut terms, improve programs and services, and try to work with judges to make them feel very comfortable that when they put somebody in probation they are more likely to do good and they will have more alternatives to revocation.
I was in Kansas in November and if you get revoked from probation on a technical violation, you basically serve six months in prison, and you get out. You don’t go back with your original sentence. In Texas you go back with your original sentence so you’re going to serve whatever, 50 percent of that, probably now, 40 percent of whatever the sentence was.
[I’m working in] Virginia—a very conservative state. One big difference is they have sentencing guidelines that are administered by the judges. They are working on a risk assessment instrument for probation and community supervision revocation that lets the judges identify where these people fall in terms of risk of coming back again. And if they fall below a certain line, the recommendation is to leave them in the community with alternative programs.
They think they can divert like 40 percent of the people that are being revoked based on this risk assessment. The people that fall in this lower category, only 17 percent were re-arrested after a two-year period compared to 48 percent for the people that fall in the higher risk. So it’s not that you have zero risk, you always have a risk. But you have to identify where these guys fall, in what group, and the judges use it and try to divert people that way.
TO: Well, the governor, when asked about Texas’ lack of capacity, says that we can just outsource to private facilities and county jails. But is that really a cost-effective solution for the state?
TF: Well, it might be cost-effective in the sense that it might cost a little bit less than housing them in the prison system. It might reduce some of the prison construction cost. If some of the privates construct their own prisons, I guess, or the counties pay them for holding them there. But the operational cost will still be large. You still have to pay for housing those people. And at one point, the question becomes, “Where’s the end of this thing? How large is this going to get?” We have 160,000 prisoners. Are we going to do this every four, five years? Buy 6,000 more prisoners? Somebody is going to have to really answer questions. And I have asked that question before. What it requires is a strong commitment to enhance other parts of this system that we have not enhanced very well.
TO: What questions should legislators be asking of the folks at the Legislative Budget Board who are doing some of what you used to do? What information will be missing that legislators should know?
TF: Let me tell you a part that was invisible. What we did a lot was serve as a neutral facilitator among the agencies to agree on what was the problem. Agree on some potential options for the problems. Agree on how we were going to approach this to provide the best information for the Legislature and the governor on what to do next. And then agree on accountability measures that the agencies will participate in to move the agenda forward. That was kind of invisible in the sense that what they tended to see were reports, projections, and so forth. But now that I’m traveling all over the country, ironically, I’m doing this role [in other states]. In this state you have all these agencies and the legislative board types and so forth, you need a mechanism for somebody that is perceived as neutral, coming in and facilitating all this work with the agencies to provide a consistent and cohesive view of what needs to get done and how you ’re going to hold everybody accountable for doing it and have everybody working together. I did a lot of that so, a question that you need to ask somebody is whether, that part, that function, has been done or somebody’s doing it. I honestly do not know. I don’t want to speculate because it sounds pretty self-serving.
TO: In your final years there, did you ever feel— I’m not saying that you gave in to it—but did you ever feel pressured to reach any kind of conclusion?
TF: No. I mean there were a lot of pressures during the last session. But everybody that knew me, knew that I would listen, try to figure out what was reasonable given the base of numbers, of information, and give them my best judgment, and that’s what they always praised me for doing. And any attempts to put pressures that were blatantly political, [they know] I will not do it, and [instead] pay the consequences.
TO: That’s pretty much what happened!
TF: I don’t know, [laughs]. But, that was my job, that’s what they paid me to be. They needed to have somebody that they saw not playing any games with the judgment calls. And many times, Republicans and Democrats—and believe me I have good friends on both sides, very good friends—[would] tell me, “maybe we don’t like what you say sometimes, but we know it’s your judgment call based on the best information that we have. And if we don’t like it, we’re going to tell you and then try to work on it. But that’s what we like, because there’s a lot of people who come here, and you know they have all kinds of agendas.” And so at a certain point they don’t believe anything and this is the problem. It becomes a game of opportunity—using information to create opportunity as opposed to using information to create options that most people think are reasonable [to provide] alternatives to whatever problem they’re facing. It’s fascinating. The use of information in a power structure is something that fascinates me and I love to watch it.
TO: One last question: Why do you think the agency was terminated?
TF: [Laughs]. I just take it as a big compliment what [they] said. We did such a good job in helping the state get out of the crisis in the early ’ 90s, that we were no longer needed! [Laughs]. So we worked ourselves out of a job! The only agency that has done that. And I appreciate the compliment.
Posted by lois at 06:47 PM | Comments (0)
Op-Ed: NY Suffolk County Should Buck States Jail Order
BY MAURICE MITCHELL
February 24, 2005
With the announcement of an almost half-billion dollar price tag, including construction and debt, Suffolk County's proposed "Super Jail" is an economic and social disaster waiting to happen.
The disclosure of this exorbitant budget marks a snag in the fast tracking of the county's largest construction project ever. With minimal public input, Suffolk has embarked on a journey all too common for localities both statewide and nationally. Given the stakes, Suffolk legislators and the county executive have an opportunity to demonstrate leadership by standing up to state mandates and rethinking the project.
Overcrowded jails and the larger, more expensive jails that replace them are symptoms of a failing criminal-justice system that needs to be re-examined. Although statistics show that incarceration is the most ineffective, expensive, inhumane feature of the criminal-justice system, it is constantly being expanded and over-funded. With almost 5 percent of the world's population and a quarter of the world's prisoners, the United States has eclipsed both China and Russia in its rate of incarceration.
The national average of inmates who return to jail is 70 percent. Furthermore, studies like those recently done through the American Bar Association confirm what members of the black and Latino communities have long maintained - prison and jail unduly and disproportionately affect communities of color. Considering these realities, incarceration is perhaps the only public project given unlimited resources despite decades of consistently horrible performance.
Crime rates and the prison population have been dropping in the past decade, but during this period an alarming trend has developed on the county level. Showing a stark disconnect from reality, the state has mandated jail expansion in 36 counties since 1995. Suffolk's proposed 1,280-bed facility is by far the largest jail the state has mandated in recent memory. The planned facility has truly earned the title "Super Jail," with approximately three times the cells of the next largest proposed jail in Dutchess County.
Though counties like Suffolk have genuine issues with overcrowding, the State Commission of Corrections displayed unprecedented authority by not only identifying the problem but also ordering the solution. In December of 2002 the Commission of Corrections dictated that Suffolk build a 1,200-bed jail facility by 2007 to remedy overcrowding. This mandate was issued with no basis in facts or research, and created a self-fulfilling prophecy. Today, after hundreds of thousands of dollars in research, consulting, and planning, the proposed facility looks exactly like the state's original prescription.
Such state micromanagement stymies innovative reforms like those recently applied in Macomb County, Mich., where nonviolent mentally ill inmates are removed from jail and given specific treatment. Other examples of non-construction solutions to jail overcrowding include the full-system overhaul conducted in Monroe County, N.Y. Officials in Monroe implemented balanced reforms from arrest to sentencing that alleviated jail overcrowding while preserving public safety. The sentencing of those caught driving with suspended licenses to community service, rather than jail, is another sensible reform.
Suffolk County Executive Steve Levy and local legislators have a duty to be responsive to their constituents, not the Commission of Corrections. This Albany-based board of unelected appointees may be over-reaching its mandate in the first place. Dutchess County Executive William R. Steinhaus recently vetoed his legislature's efforts to fund a mandated jail. Alternatively, Suffolk County should follow the lead of Tompkins County, which in early December dropped construction plans altogether in defiance of the Commission of Corrections. Although its project is dwarfed by Suffolk's, Tompkins officials set a precedent, proving that the Commission of Corrections' directives are not sacrosanct.
If Suffolk legislators continue to ignore pleas from t